Effect of general anesthesia combined with epidural anesthesia on the short-term cognitive function in the elderly patients after orthopedics surgery / 中华老年医学杂志

ABSTRACT

Objective To observe the effects of general anesthesia combined with epidural anesthesia on the short-term cognitive function in the elderly patients after orthopedics surgery.Methods 185 elderly patients undergoing orthopedics surgery were treated in our hospital from Jan.2011 to Jan.2014.The patients were divided into observation group (with general anesthesia combined with epidural anesthesia,n=94) and control group (with general anesthesia,n=91).The short term cognitive function,mean arterial pressure and heart rate were compared at 30 min before,during and at the end of the operation between the two groups.Results There were no statistically significant differences in awakening time,extubation time and response time between the two groups [(28.7±7.8) min vs.(30.9±8.1) min,(29.2±8.1) min vs.(32.2±8.4) min,(30.4±7.9) min vs.(33.1±8.6) min,t=1.881,2.472,1.943,respectively,P=0.031,0.007,0.027].The minimental state examination (MMSE) scores were higher in observation group than in control group at 6,12 and 24 hours after surgery [(26.1±1.4) vs.(24.9±1.5),(25.0±1.5) vs.(24.1±1.4),(27.9 ±1.4) vs.(26.3±1.3),t=5.627,3.279,8.049,all P＜0.001].The incidence of cognitive dysfunction was less in observation group than in control group at 6 and 12 hours after surgery (7.5％ vs.17.6％,8.5％ vs.19.8％,x2=4.363,4.862,respectively,P=0.037,0.027).Conclusions Compared with general anesthesia,the general anesthesia combined with epidural anesthesia can reduce the effects of anesthesia on cognitive dysfunction,and has a good effect of anesthesia.It is more suitable for the elderly patients with anesthesia for surgery.